Oestrogen possible treatment in menopause also at increased risk of cardiovascular disease

A new population study from Karolinska Institutet shows that women with an increased risk of cardiovascular disease may benefit from oestrogen treatment for menopausal problems, something that has so far been advised against. Researchers have studied 41,000 Swedish women who were treated with cholesterol-lowering drugs, and the results are being published in the journal Menopause.

“The proportion of women treated with oestrogens during menopause has decreased in recent years, for several reasons”, says first study-author Dr. Ingegärd Anveden Berglind. “At the same time, many women going through menopause have explicit problems with hot flashes, sleeping, osteoporosis, and mild depression, which often can be treated successfully with oestrogens. The results of this study could be of value for evaluating risk and benefit of oestrogen treatment for menopause related conditions.”

According to current treatment recommendations, women who are at an increased risk of cardiovascular disease should be treated with oestrogenes for menopausal problems with caution. These recommendations were designed based on the results from two major studies conducted in the beginning of the 2000s, which showed that women treated with oestrogens were at an increased risk of falling ill from cardiovascular disease. In the current study, researcher at the Centre for Pharmacoepidemiology at Karolinska Institutet studied oestrogen treatment and the risk of cardiovascular disease and mortality among women treated with so-called statins.

Simultaneously treated

Statins are a commonly used as cholesterol-lowering treatment to prevent cardiovascular disease in patients with an increased risk of such disease; in all 10 percent of the Swedish adult population are being treated with these drugs. The current study included 41,000 women, ages 40 to 75, treated with statins. A little more than 2,800 (7%) of these women were simultaneously treated with oestrogens. Risk of disease and mortality were studied by comparing women with our without oestrogen treatment.

The results show that the risk of death was almost halved in women treated with oestrogen, and that there were no increased risk of cardiovascular disease during the four years of follow-up. Researchers therefor draw the conclusion that oestrogens do not increase the risk of cardiovascular disease and death in women treated with statins.

The work conducted at the Centre for Pharmacoepidemiology is funded by grants from grants from several entities, including pharmaceutical companies, regulatory authorities, and contract research organisations. This study was independently developed from a project sponsored by AstraZeneca, Merck Sharp & Dhome, and Pfizer.